降钙素原检测对重症急性胰腺炎并发感染的诊断价值分析  

Diagnostic value of calcitonin in patients with severe acute pancreatitis complicated with infection

作　　者：聂胜利[1] 吴伍林[2] 王蓓蓓[1] 张庆芳[1] 吴军辉[1] Nie Shengli Wu Wulin Wang Beibei Zhang QinJang Wu Junhui(Department of Gastroenterology, Guangdong Academic of Medical Sciences, Guangdong General Hospital, Institute of Geriatrics, Guangzhou 510080, China Department of General Surgery, Guangdong Academic of Medical Sciences, Guangdong General Hospital, Institute of Geriatrics, Guangzhou 510080, China)

机构地区：[1]广东省人民医院暨广东省医学科学院消化科,广州510080 [2]广东省人民医院暨广东省医学科学院普外科,广州510080

出　　处：《中华普外科手术学杂志（电子版）》2017年第2期162-164,共3页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

摘　　要：目的探讨降钙素原(PCT)对重症急性胰腺炎并发感染的诊断价值。方法回顾性分析2015年8月至2016年8月70例重症急性胰腺炎患者资料,根据患者有无并发感染将其分为并发感染组(35例)和未感染组(35例),观察分析两组患者的临床体征和检测指标。所有数据用SPSS19.0统计学软件分析,PCT、C反应蛋白(CRP)和白细胞(WBC)含量以均数±标准差(±s)表示,采用t检验;并发症发生情况采用卡方检验;P<0.05表示差异有统计学意义。结果患者入院时,并发感染组患者血清PCT(4.4±2.7)ng/ml明显高于未感染组(0.05±0.01)ng/ml,(P<0.05),而CRP、WBC两组差异无统计学意义(P>0.05);并发感染组第1、7、14、21天PCT水平[(5.5±3.2)、(10.6±2.1)、(3.3±0.2)、(0.7±0.1)ng/ml]明显高于未感染组[(1.5±0.7)、(0.9±0.3)、(0.2±0.03)、(0.5±0.1)ng/ml](P<0.05);并发感染组患者无并发症如休克、弥散性血管内凝血DIC、消化道出血、死亡等病例发生,而未感染组的发生率分别为8.6%、11.4%、5.7%、5.7%,两组差异有显著统计学意义(P<0.05)。结论检测PCT水平可以提高急性胰腺炎并发感染诊断的准确性,为临床治疗提供依据,有助于防治急性胰腺炎患者发生感染,推荐临床诊断应用并推广。Objective To investigate the diagnostic value of Procalcitonin（PCT）in patients with severe acute pancreatitis complicated with infection.Methods From August 2015 to August 2016,clinical data of 70 patients with severe acute pancreatitis were analyzed retrospectively,including 35 cases in infection group and 35 cases in control group,while clinical signs and physical index of patients were observed.Statistical analysis were performed by using SPSS 19.0 software,Measurement data such as PCT,CRP,WBC levels were expressed as mean＆#177;standard deviation（x±s）,and were examined by using t test.Count data,such as complication rate,were expressed as%,and were examined by using x2 test.A P value ＆lt;0.05 was considered as statistically significant difference.Results At the admission,patients＇ serum PCT of（4.4±2.7）ng/ml in infection group were significantly higher than（0.05±0.01）ng/ml in control group（P〈0.05）.However,there were no significant difference between 2 groups in terms of C reactive protein（CRP）and WBC（P〉0.05）.In infection group,serum PCT were（5.5±3.2）、（10.6±2.1）、（3.3±0.2）and（0.7±0.1）ng/ml at day 1,day 7,day 14 and day 21,which were significantly higher than（1.5±0.7）、（0.9±0.3）、（0.2±0.03）amd（0.5±0.1）ng/ml in control group respectively（P〈0.05）.In infection group,there was no complication such as diffuse intravascular coagulation,gastrointestinal bleeding,death cases,but complications rate in control group were 8.6%,11.4%,5.7%and 5.7%,respectively,with significant difference（P〈0.05）.Conclusion The detection of procalcitonin levels could improve the accuracy of diagnosis of acute pancreatitis complicated with infection,and could provide the basis for clinical treatment,which is worthy of promotion.

关 键 词：胰腺炎 急性坏死性 降钙素 诊断 

分 类 号：R576[医药卫生—消化系统]